[Instalasi gawat darurat (IGD) rumah sakit adalah bagian dari rumah sakit yang memberikan layanan terdepan. Di Rumah Sakit dr. Mohammad Hoesin (RSMH) Palembang sudah terdapat IGD berdasarkan SK Direktur Utama Rumah Sakit yang menetapkan struktur organisasi, tugas dan tanggung jawab, visi dan misi, dan prosedur tetap pelayanan gawat darurat. IGD RSMH Palembang dikepalai oleh seorang dokter spesialis bedah urologi dibantu oleh dua orang kepala ruangan.Standar pelayanan di IGD sudah menerapkan standar layanan sesuai dengan standar akreditasi KARS 2012. IGD keberadaannya di rumah sakit diatur oleh Kepmenkes RI No. 856/Menkes/SK/IX/2009 tentang Standar IGD. Kepemenkes ini mengatur tentang standarisasi pelayanan gawat darurat di rumah sakit, dalam Kepmenkes tersebutdiatur standar organisasi, sumber daya manusia, pelayanan, kelengkapan sarana prasarana di IGD. Di RSMH Palembang telah dilaksanakan dokter spesialis jaga on site di IGD sejak 30 Januari 2014 sebagai tindak lanjut Kepmenkes RI tersebut. Sejak dilaksanakan kebijakan dokter spesialis jaga on site di IGD masih dijumpai kepatuhan para dokter masih belum optimal dan walaupun mutu layananan semakin membaik sejalan dengan telah terakreditasi paripurna rumah sakit versi KARS 2012. Penelitian ini bertujuan untuk mengetahui bagaimana implementasi kebijakan dokter spesialis jaga on site di IGD sudah dilaksanakan sesuai dengan tujuan yang diharapkan sesuai dengan Kepmenkes. Penelitian dilakukan dengan metode kualitatif melalui wawancara mendalam pada informan. Informan yang diwawancarai adalah jajaran Direktur RSMH Palembang, Ketua Komite Medik, Kabag. Keuangan, Kepala ruangan IGD dan para dokter spesialis. Penilaian hasil wawancara menggunakan kerangka fikir model implementasi kebijakan George Edward III dengan variabelsumber daya, komunikasi, disposisi dan struktur organisasi.Dari hasil penelitian ini didapatkan implementasi kebijakan dokter spesialis jaga on site belum berjalan dengan baik, disebabkan karena faktor komunikasi, disposisi dan struktur organisasi belum berjalan baik dan masih banyak perlu dukungan sumber daya. Usulan yang diberikan adalah penambahan dan kompetensi tenaga sesuai standar, revisi SOP, penyediaan media komunikasi, perbaikan fasilitas,meningkatkan koordinasi dan fungsi pengawasan secara berkala, advokasi ke Kemenkes RI.;Emergency department (ED) is a part of hospital which giving advanced services. In dr. Mohammad Hoesin (RSMH) Palembang hospital already own an emergency department based on SK director of the hospital whom establishes the organizational structure, duties and responsibilities, vision and mission, and standard operating procedures emergency services. ED RSMH Palembang is lead by a specialist urology and assisted by two heads of the room. Standard service of ED has implementing service standards according to accreditation standards KARS 2012. ED in the hospital arranged Indonesian health minister No. 865/Menkes/SK/IX/2009 about ED standards. The head of health minister regulates the standardization of emergency services at the hospital, which managing standard organizations, human resources, services, completeness infrastructure in ED. RSMH Palembang has been implemented specialist doctors duty on site in the ER since January, 30th 2014 as a follow-up of the head of the Indonesian health minister. Ever since implemented a policy specialist on duty in the ER site still found the compliance of the doctors are still not optimal and although the quality of service has improved in line with acreditation hospital KARS version 2012. This research aims to determine how the implementation of policy specialists doctors on site in the ER has been implemented in accordance with the expected goals in accordance with the head of health minister. Research done with qualitative method by performing in-depth interviews on informants. Informants interviewed are RSMH Palembang board of directors, chairman of the medical committee, chief financial officer, head of the ED room and specialist doctors. Assessment interview results are using logical framework policy implementation model George Edward III with variable resources, communications, disposition and organizational structure. From the results of this study, the implementation of policy specialist doctorson site guard has not run well, due to the communication factor, disposition and organizational structure has not been going well and much needed resource support. The given proposal is the addition of appropriate power and competence standards, the revised SOP, provision of communication media, improvement of facilities,improving the coordination and monitoring functions regularly, advocacy to the head of the Indonesian health minister, Emergency department (ED) is a part of hospital which giving advancedservices. In dr. Mohammad Hoesin (RSMH) Palembang hospital already own anemergency department based on SK director of the hospital whom establishes theorganizational structure, duties and responsibilities, vision and mission, and standardoperating procedures emergency services. ED RSMH Palembang is lead by aspecialist urology and assisted by two heads of the room. Standard service of ED hasimplementing service standards according to accreditation standards KARS 2012.ED in the hospital arranged Indonesian health minister No.865/Menkes/SK/IX/2009 about ED standards. The head of health minister regulatesthe standardization of emergency services at the hospital, which managing standardorganizations, human resources, services, completeness infrastructure in ED. RSMHPalembang has been implemented specialist doctors duty on site in the ER sinceJanuary, 30th 2014 as a follow-up of the head of the Indonesian health minister. Eversince implemented a policy specialist on duty in the ER site still found thecompliance of the doctors are still not optimal and although the quality of service hasimproved in line with acreditation hospital KARS version 2012.This research aims to determine how the implementation of policy specialistsdoctors on site in the ER has been implemented in accordance with the expectedgoals in accordance with the head of health minister. Research done with qualitativemethod by performing in-depth interviews on informants. Informants interviewed areRSMH Palembang board of directors, chairman of the medical committee, chieffinancial officer, head of the ED room and specialist doctors. Assessment interviewresults are using logical framework policy implementation model George Edward IIIwith variable resources, communications, disposition and organizational structure.From the results of this study, the implementation of policy specialist doctorson site guard has not run well, due to the communication factor, disposition andorganizational structure has not been going well and much needed resource support.The given proposal is the addition of appropriate power and competence standards,the revised SOP, provision of communication media, improvement of facilities,improving the coordination and monitoring functions regularly, advocacy to the headof the Indonesian health minister] |